Application of Bilateral Cerebral Perfusion + Balloon Occlusion of Descending Aorta + Antegrade Perfusion of Lower Body in Debakey Type I Aortic Dissection.

Abstract

Objective: To evaluate the efficacy of a new perfusion method in DeBakey Type I aortic dissection surgery, with the goal of enhancing thorough organ protection and optimising patient outcomes.

Study design: Descriptive study. Place and Duration of the Study: Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of the University of South China, from January 2020 to December 2021.

Methodology: Thirty-two patients undergoing total aortic arch replacement with descending aortic stenting were included in the study. The new perfusion method involved a combination of bilateral selective cerebral perfusion, descending aortic balloon occlusion, and antegrade lower body perfusion. Lower limb ischaemic complications and mortality rate were the main outcome measures. Surgical procedures and patient data were collected and analysed.

Results: No cases of paraplegia, intestinal necrosis, or lower-limb ischaemia were observed. The new perfusion method effectively protected lower-body organs, with a short duration of lower-body ischaemia during surgery. The overall mortality rate was 3.13%, and postoperative complications were minimal, resulting in satisfactory survival rates.

Conclusion: The combination of perfusion techniques, including bilateral selective cerebral perfusion, descending aortic balloon occlusion, and anterograde lower body perfusion, proved effective in improving the outcomes for DeBakey Type I aortic dissection surgery. Further research is needed to confirm the long-term benefits of this approach.

Key words: DeBakey type I aortic dissection, Descending aortic balloon blockade, Lower body anterograde perfusion, Bilateral selective cerebral perfusion.